Saving And Empowering Young Lives In Europe Research Articles

Doing Nothing is Sometimes Worse: Comparing Avoidant versus Approach Coping Strategies with Peer Victimization and Their Association to Depression and Suicide Ideation

ABSTRACT Peer victimization is a major stressor adolescents often face in the school environment, and has been linked to depression and suicidal risk. This study analyzed the associations between three behavioral coping strategies (avoidance, seeking social support from adults/peers, and retaliation) and depression and suicidal ideation. Participants included 4,254 victimized students who were part of the Saving and Empowering Young Lives in Europe (SEYLE) study that compared three school-based prevention interventions and collected information on health risk behaviors in adolescents from 11 European countries. Results showed behavioral avoidance to be associated with an increase in levels of depression, as compared to the other coping strategies (adult social support, peer social support, retaliation). Seeking social support from adults was associated with lower depression and suicidal ideation rates. A more than 25% increase in suicidal ideation was associated with behavioral avoidance, compared to seeking social support from adults. By contrast, retaliation to peer victimization was not found to be associated with increased depression or suicidal ideation. The findings support the Coping Deficit model and may suggest that abstaining by doing nothing when victimized can be associated with certain adverse emotional outcomes.

Suicide Prevention in the European Region.

Although the majority of the world's suicides occur in Asia, suicide and self-harm are major concerns in Europe as well. Suicide accounts for 1.4% of the total number of deaths in Europe, with rates highest among those aged over 70 and also high among those aged 45-59 years. Europe accounts for six of the top ten countries with the highest suicide rates internationally. Although rates of suicide attempts and self-harm are not consistently recorded, evidence from hospital-based studies and school-based surveys highlight their extent and scale. Numerous countries in Europe have developed national suicide prevention strategies and action plans. Some of the suicide prevention activities in Belgium, Estonia, Finland, Scotland, France, Germany, Romania, Russia, Sweden, Ukraine, and Italy are summarized. In the chapter we also highlight novel suicide prevention projects funded by the EU which have advanced our understanding of suicide risk and have developed the evidence base for what works to prevent suicide. Examples include the European Alliance Against Depression (EAAD), Saving and Empowering Young Lives in Europe (SEYLE), Suicide Prevention Through Internet and Media Based Mental Health Promotion (SUPREME), and Reduction of Suicides and Trespasses on Railway Property (RESTRAIL). Future challenges and opportunities for suicide prevention in Europe are also discussed.

Influence of coping strategies on the efficacy of YAM (Youth Aware of Mental Health): a universal school-based suicide preventive program.

The school-based mental health promotion and suicide prevention universal program Youth Aware of Mental Health (YAM) significantly reduces incident suicide attempts and severe suicidal ideation. This paper aims at elucidating psychological mechanisms underlying YAM's efficacy. Our hypothesis is that YAM operates through interactions with coping strategies (CS) on the reduction of suicidal ideation (SI). In the Saving and Empowering Young Lives in Europe (SEYLE) study, five coping strategies were assessed at baseline (T0) and 12-month follow-up (T12): "learning", "help-seeking", "arts", "sports" and "fight". We analyzed interactions between the YAM intervention, coping strategies and SI in the YAM group (N = 1693) and the minimal intervention group (N = 1909), after excluding prevalent cases with SI and previous suicide attempts from our total sample (N = 5654). General Linear Mixed Model regressions were performed. The present study confirms that coping strategies play an influential role on suicidal ideation. Our results showed that YAM acts whatever the prevailing coping strategies used. It is particularly efficient for pupils insufficiently using adaptive coping strategies such as LEARN and HELP-SEEKING or using maladaptive coping strategies, such as ARTS and FIGHT. The socialization induced by the YAM intervention seems to be a strong component of its efficiency.

A longitudinal examination of the interpersonal theory of suicide and effects of school-based suicide prevention interventions in a multinational study of adolescents.

Predictions of two different models for suicide attempts (SA) over 12 months, as differentially impacted by specific school-based suicide prevention interventions, were compared. These were as follows: (a) interpersonal theory (IPTS) and (b) a two-pathway model, one path associated with externalizing symptoms and continuum of self-harm behaviors, and the other with internalizing symptoms. Self-report questionnaires were completed by 11,110 high school students from ten EU countries enrolled in the Saving and Empowering Young Lives in Europe (SEYLE) study. Baseline measures included perceived burdensomeness, thwarted belongingness from parents and peers, health risk behaviors, self-injury, suicide ideation (SI), and attempts (SA). SI and SA were reassessed at 12-month follow-up. Each model's predictions of SI and SA groups over time (i.e., repeated SA, remitted SA, SA onset, and no SA) were estimated in the no intervention/control group. The superior model was estimated across intervention groups. Interpersonal theory showed better fit compared to the two-pathway model. In partial agreement with IPTS predictions, parental low belongingness but not peer belongingness or burdensomeness predicted greater likelihood of SI. The likelihood of repeated SA versus no SA was higher among adolescents who reported SI, self-injury, risk behaviors, and particularly both SI and self-injury. All three interventions attenuated the combined effect of SI and self-injury. Youth Aware of Mental Health Program (YAM) additionally decreased the effect of risk behaviors on the likelihood of repeated SA. Interpersonal theory assumptions were partially supported. Perceived interpersonal difficulties with parents were primarily related with SI, and risk behaviors and self-injury were important predictors of SA. Suicide prevention interventions may be effective by mitigating the hazardous effect of varying self-harm behaviors and may be further advanced by increasing parental involvement.

Bi-directional longitudinal associations between different types of bullying victimization, suicide ideation/attempts, and depression among a large sample of European adolescents.

The association between bullying victimization and depression, suicide ideation and suicide attempts has been studied mainly in cross-sectional studies. This study aims to test the bidirectional effect and the chronicity versus sporadic effect of physical, verbal, and relational bullying victimization on suicidal ideation/attempts and depression. Longitudinal assessments with an interval of 3- and 12-months were performed within a sample of 2,933 adolescents (56.1% females; mean age 14.78, SD=.89) from 10 European countries, participating in the Saving and Empowering Young Lives in Europe (SEYLE) school-based multicenter control sample. Multilevel Structural Equation Models were used, controlling for sociodemographic variables. Victimization was considered chronic when a student was victimized in the first two time points and sporadic when it was reported only at one point but not in another. Bidirectional prospective association between all types of victimization and depression were found. Among participants, who reported victimization once (but not twice), physical victimization, but not verbal and relational, was associated with later suicidal ideation and attempts. Chronic victimization of any type increased likelihood for later depression compared with sporadic and no-victimization. Chronic relational victimization increased the likelihood of later suicidal ideation, and chronic physical victimization increased the likelihood for suicidal attempts. The results support the bidirectional effect of victimization and depression and indicate that there are complex longitudinal associations between victimization and suicidal ideation/attempts. Physical victimization may especially carry effect on suicidal risk over time. Interventions should focus on victimization as a cause of distress but also aim to prevent vulnerable adolescents from becoming targets of victimization.

A cost-effectiveness analysis of school-based suicide prevention programmes

Suicide is one of the leading causes of death among young people globally. In light of emerging evidence supporting the effectiveness of school-based suicide prevention programmes, an analysis of cost-effectiveness is required. We aimed to conduct a full cost-effectiveness analysis (CEA) of the large pan-European school-based RCT, Saving and Empowering Young Lives in Europe (SEYLE). The health outcomes of interest were suicide attempt and severe suicidal ideation with suicide plans. Adopting a payer's perspective, three suicide prevention interventions were modelled with a Control over a 12-month time period. Incremental cost-effectiveness ratios (ICERs) indicate that the Youth Aware of Mental Health (YAM) programme has the lowest incremental cost per 1% point reduction in incident for both outcomes and per quality adjusted life year (QALY) gained versus the Control. The ICERs reported for YAM were €34.83 and €45.42 per 1% point reduction in incident suicide attempt and incident severe suicidal ideation, respectively, and a cost per QALY gained of €47,017 for suicide attempt and €48,216 for severe suicidal ideation. Cost-effectiveness acceptability curves were used to examine uncertainty in the QALY analysis, where cost-effectiveness probabilities were calculated using net monetary benefit analysis incorporating a two-stage bootstrapping technique. For suicide attempt, the probability that YAM was cost-effective at a willingness to pay of €47,000 was 39%. For severe suicidal ideation, the probability that YAM was cost-effective at a willingness to pay of €48,000 was 43%. This CEA supports YAM as the most cost-effective of the SEYLE interventions in preventing both a suicide attempt and severe suicidal ideation.Trial registration number DRKS00000214.

Explicit Motives, Antecedents, and Consequences of Direct Self-Injurious Behaviors.

Self-injurious behaviors in adolescence are a serious public health concern. The current study aims to expand our understanding of motives for direct self-injurious behaviors (D-SIB). We examined the explicit motives but also the actual antecedents and consequences of D-SIB over time. As part of the Saving and Empowering Young Lives in Europe (SEYLE) study, adolescents between the ages of 14 and 18 years from Israel completed self-report questionnaires at baseline, 3-month, and 12-month follow-ups. Decreases in social support predicted later increases in D-SIB, an effect mediated by negative affect. Both peer and parental support also exerted quadratic effects on D-SIB. Thus, low as well as high support predicted subsequent D-SIB. In turn, D-SIB was followed by increased peer and parental support. Our methodology relies on self-reports, affected by social desirability and recall biases. The findings support a causal path for the development of D-SIB: from interpersonal distress to emotional distress and then to D-SIB. They also point to interesting avenues regarding subgroupings of adolescents who self-injure depending on their motives. Finally, our results reveal that D-SIB, although of negative import, might paradoxically be effective in serving certain functions such as gaining support from parents and peers.

Mental health difficulties and suicidal behaviours among young migrants: multicentre study of European adolescents.

BackgroundMigration has been reported to be associated with higher prevalence of mental disorders and suicidal behaviour.AimsTo examine the prevalence of emotional and behavioural difficulties, suicidal ideation and suicide attempts among migrant adolescents and their non-migrant peers.MethodA school-based survey was completed by 11 057 European adolescents as part of the Saving and Empowering Young Lives in Europe (SEYLE) study.ResultsA previous suicide attempt was reported by 386 (3.6%) adolescents. Compared with non-migrants, first-generation migrants had an elevated prevalence of suicide attempts (odds ratio (OR) 2.08; 95% CI 1.32–3.26; P=0.001 for European migrants and OR 1.86; 95% CI 1.06–3.27; P=0.031 for non-European migrants) and significantly higher levels of peer difficulties. Highest levels of conduct and hyperactivity problems were found among migrants of non-European origin.ConclusionsAppropriate mental health services and school-based supports are required to meet the complex needs of migrant adolescents.Declaration of interestNone.Copyright and usage© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

Substance use or abuse, internet use, psychopathology and suicidal ideation in adolescents.

Substance and Internet use or abuse, psychopathology and suicidal ideation appear to be related. The aim of this study is to investigate the association between use of psychotropic substances, inadequate Internet use, suicidal ideation and other psychopathological symptoms within the adolescent population. The present study was carried out as part of the Saving and Empowering Young Lives in Europe (SEYLE) project, funded by the European Union. The sample is composed of 1026 adolescents aged between 14 and 16 years from 12 state schools in Asturias (530 men and 496 women). This study adds to the possibility of knowing whether the SEYLE data is confirmed in a relatively isolated and recession hit province of Spain. In the present study the following consumption rates were obtained: a) alcohol 11.89% in males and 7.86% in females; b) tobacco: 4.15% and 5.44 % in males and females respectively; c) other drugs: 6.98% in males and 4.44% in females; d) maladaptive or pathological Internet use: 14.53% and 20.77% in males and females respectively. The variables that predict suicide ideation in the logistic regression model were: previous suicide attempts, depression, maladaptive or pathological Internet use, peer problems and alcohol consumption.

Review of health and risk-behaviours, mental health problems and suicidal behaviours in young Europeans on the basis of the results from the EU-funded Saving and Empowering Young Lives in Europe (SEYLE) study.

An estimated 800 000 suicide deaths occur worldwide. The global suicide rate is 11.4 per 100 000 population; 15.0/100 000 for males and 8.0/100 000 for females. Globally, suicide is the second leading cause of death in 15-29 year olds. In a collaborative effort to reduce the high rates of suicide and mental health problems among youth across Europe, the European Union 7th Framework funded the Saving and Empowering Young Lives in Europe (SEYLE) project. SEYLE is a randomized controlled trial (RCT) aimed to promote mental health and healthy lifestyles, while preventing psychopathology and suicidal behaviours among adolescents. The epidemiological data on 11,110 pupils in the age group 14-16 years, with a mean age of 14.8 years (SD ± 0.8), who were recruited from 168 schools across 10 European Union countries: Austria, Estonia, France, Germany, Hungary, Ireland, Italy, Romania, Slovenia and Spain, with Sweden as the coordinating centre showed the following prevalences: alcohol use (13.4%), smoking (30.9%), physical inactivity (32.8%), pathological Internet use (4.4%) and sleeping on average 7.7 hours per night. In terms of reproductive health, the prevalence of sexual debut was 18.8% for the total sample. Pupils aged .16 years had a higher prevalence (38%) of sexual debut compared to those aged .15 years (13.2%). Males had a higher prevalence (21.3%) than females (16.9%). Three clusters of adolescents were identified: 57.8% with low frequency of all risk-behaviours; 13.2% with high frequency of all risk behaviours; and 29% so-called 'invisible' risk group, which did not show any striking externalised riskbehaviours, but scored positive for high use of Internet/TV/videogames, sedentary behaviour and reduced sleep. When comparing pupils in the "invisible" risk group with those in the high-risk group, similar prevalence rates of anxiety (8% vs. 9.2%), subthreshold depression (33.2% vs. 34%), depression (13.4% vs. 14.7%) and suicidal thoughts (42.2% vs. 44%) were observed. Pupils meeting the criteria of depression and subthreshold depression were 10.5% and 32%, respectively. Prevalence rates for anxiety and subthreshold anxiety was 5.8% and 29.2%, respectively. Lifetime prevalence of deliberate self-injurious behaviours (D-SIB) was 27.6%, with higher rates reported for occasional D-SIB (19.7%) compared to repetitive D-SIB (7.8%). Suicidal ideation was present in approximately one third of the sample (32.3%). More than four percent (4.2%) of the sample reported attempting suicide during their lifetime, with a significantly higher prevalence among girls (5.1% vs. 3.0%, p<0.05). In comparing the effectiveness of the three active SEYLE interventions, based on three specific preventive strategies directed towards teachers and school staff, professionals and pupils in comparison to a control group, the intervention empowering pupils, called the Youth Aware of Mental Health (YAM) showed significant results in preventing new cases of suicide attempts, severe suicidal ideation with plans and depression. More than a 50% reduction of incident cases of suicide attempts (OR: 0.45 [0.24 - 0.85]; p=0.014), and of incident cases of severe suicidal ideation and plans (OR: 0.50 [0.27 - 0.92]; p=0.025), as well as a significant reduction by 30% of incident cases with moderate to severe depression (OR: 0.71 [0.52- 0.97]; p=0.031) was observed.

Physical activity in European adolescents and associations with anxiety, depression and well-being.

In this cross-sectional study, physical activity, sport participation and associations with well-being, anxiety and depressive symptoms were examined in a large representative sample of European adolescents. A school-based survey was completed by 11,110 adolescents from ten European countries who took part in the SEYLE (Saving and Empowering Young Lives in Europe) study. The questionnaire included items assessing physical activity, sport participation and validated instruments assessing well-being (WHO-5), depressive symptoms (BDI-II) and anxiety (SAS). Multi-level mixed effects linear regression was used to examine associations between physical activity/sport participation and mental health measures. A minority of the sample (17.9% of boys and 10.7% of girls; p<0.0005) reported sufficient activity based on WHO guidelines (60min+daily). The mean number of days of at least 60min of moderate-to-vigorous activity in the past 2weeks was 7.5±4.4 among boys and 5.9days±4.3 among girls. Frequency of activity was positively correlated with well-being and negatively correlated with both anxiety and depressive symptoms, up to a threshold of moderate frequency of activity. In a multi-level mixed effects model more frequent physical activity and participation in sport were both found to independently contribute to greater well-being and lower levels of anxiety and depressive symptoms in both sexes. Increasing activity levels and sports participation among the least active young people should be a target of community and school-based interventions to promote well-being. There does not appear to be an additional benefit to mental health associated with meeting the WHO-recommended levels of activity.

Identifying Ethical Issues in Mental Health Research with Minors Adolescents: Results of a Delphi Study.

Research with minors, especially for preventive purposes, e.g., suicide prevention, investigating risk or self-destructive behaviors such as deviance, drug abuse, or suicidal behavior, is ethically sensitive. We present a Delphi study exploring the ethical implications of the needs formulated by researchers in an international pre-conference who would benefit from ethics support and guidance in conducting Mental Health Research with minors. The resulting List of Ethical Issues (LEI) was submitted to a 2-rounds Delphi process via the Internet, including 34 multidisciplinary experts. In the first round, the experts reviewed the LEI and completed a questionnaire. Results from this round were analyzed and grouped in nine categories comprising 40 items. In the second round, the experts had to agree/disagree with the needs expressed in the LEI leading to a final list of 25 ethical issues considered relevant for Mental Health Research with minors such as: confidentiality of the sensitive data, competence for consenting alone and risk of harm and stigma related to the methodology used in research. It was shown that studies like SEYLE (Saving and Empowering Young Lives in Europe) trigger among researchers wishes to obtain specific recommendations helping to comply with standards for good practice in conducting research with minors.

Association between victimization by bullying and direct self injurious behavior among adolescence in Europe: a ten-country study.

Previous studies have examined the association between victimization by bullying and both suicide ideation and suicide attempts. The current study examined the association between victimization by bullying and direct-self-injurious behavior (D-SIB) among a large representative sample of male and female adolescents in Europe. This study is part of the Saving and Empowering Young Lives in Europe (SEYLE) study and includes 168 schools, with 11,110 students (mean age=14.9, SD=0.89). Students were administered a self-report survey within the classroom, in which they were asked about three types of victimization by bullying (physical, verbal and relational) as well as direct self-injurious behavior (D-SIB). Additional risk factors (symptoms of depression and anxiety, suicide ideation, suicide attempts, loneliness, alcohol consumption, drug consumption), and protective factors (parent support, peer support, pro-social behavior) were included. The three types of victimization examined were associated with D-SIB. Examination of gender as moderator of the association between victimization (relational, verbal, and physical) and D-SIB yielded no significant results. As for the risk factors, depression, but not anxiety, partially mediated the effect of relational victimization and verbal victimization on D-SIB. As for the protective factors, students with parent and peer support and those with pro-social behaviors were at significantly lower risk of engaging in D-SIB after being victimized compared to students without support/pro-social behaviors. This large-scale study has clearly demonstrated the cross-sectional association between specific types of victimization with self-injurious behavior among adolescents and what may be part of the risk and protective factors in this complex association.

Pathological Internet Use and Risk-Behaviors among European Adolescents.

Risk-behaviors are a major contributor to the leading causes of morbidity among adolescents and young people; however, their association with pathological Internet use (PIU) is relatively unexplored, particularly within the European context. The main objective of this study is to investigate the association between risk-behaviors and PIU in European adolescents. This cross-sectional study was conducted within the framework of the FP7 European Union project: Saving and Empowering Young Lives in Europe (SEYLE). Data on adolescents were collected from randomized schools within study sites across eleven European countries. PIU was measured using Young’s Diagnostic Questionnaire (YDQ). Risk-behaviors were assessed using questions procured from the Global School-Based Student Health Survey (GSHS). A total of 11,931 adolescents were included in the analyses: 43.4% male and 56.6% female (M/F: 5179/6752), with a mean age of 14.89 ± 0.87 years. Adolescents reporting poor sleeping habits and risk-taking actions showed the strongest associations with PIU, followed by tobacco use, poor nutrition and physical inactivity. Among adolescents in the PIU group, 89.9% were characterized as having multiple risk-behaviors. The significant association observed between PIU and risk-behaviors, combined with a high rate of co-occurrence, underlines the importance of considering PIU when screening, treating or preventing high-risk behaviors among adolescents.

Unhealthy behaviours and mental health among Italian adolescents

Introduction A great number of studies describe reciprocal associations between unhealthy behaviours, such as poor sleep and nutrition and lack of physical activity, and mental health problems. Aims To investigate the relationship between unhealthy behaviours and depression, anxiety and well-being among Italian adolescents. Methods The sample comprised 1195 high-school pupils (mean age 15.3±0.6; 68% females) participating to the SEYLE (Saving and Empowering Young Lives in Europe) study, a randomized controlled trial, co-funded by the EU. Depression, anxiety and well-being were assessed using the Beck Depression Inventory II, the Zung Self-Assessment Anxiety Scale and the WHO-5 index. Unhealthy behaviours, such as short or long sleep, physical inactivity, skipping breakfast and not eating fruit and vegetables were also investigated. Results Controlling for age and gender, the unhealthy behaviours, with the exception of not eating fruit and vegetables, were all associated with poor level of well-being ( P P P Conclusions Unhealthy behaviours are often established early in life and are likely to be maintained during adulthood implying negative consequences for both physical and psychological well-being. Early combined health and mental health promotion programme should be implemented in order to boost their effectiveness.

Screening Adolescents: Helping to Unblock Psychiatric Services

Screenings are accused of referring too many people when most countries experience difficulties in providing timely care due to congested mental health services. One of the aims of the SEYLE (”Saving and Empowering Young Lives in Europe“) study was to test different suicide-preventive interventions. In France, 235 students were screened at baseline for psychopathology and risk behaviors via a questionnaire and a clinical interview followed by a phone report to the parents. The whole cohort (1007) was similarly screened to detect at high suicidal risk students at baseline, 3 months and 12 months. All detected students benefited from a facilitator follow-up for eventual further assistance. A total of 266 students were considered at risk (psychopathological symptoms, risk behaviors and high suicidal risk) via the questionnaire. 74 of the 245 students (30,2%) seen in clinical interview were referred for further treatment: 65 to adolescent mental health services (87,8%) and 9 to adolescent support services(12,2%). All students referred to the adolescent support services agreed to the referral whereas 54 (83,1%) of the 65 medical services referred students agreed and 11 (16,9%) refused. A qualitative report of the French SEYLE facilitator showed that for some students (including those who refused the referral), the clinical interview and the report to the parents had been beneficial enough to avoid making an appointment to mental health services. This aspect of screenings should be taken into account in further research and mental health promotion plans.

Help-seeking behaviour following school-based screening for current suicidality among European adolescents.

To screen and clinically interview European adolescents reporting current suicidality (suicidal ideation and suicide attempt) and investigate attendance at the clinical interview. The Saving and Empowering Young Lives in Europe (SEYLE) Project was carried out in 11 European countries. A baseline questionnaire was completed in school by 12,395 adolescents (mean age 14.9; SD 0.9). Those who screened positive for suicidality (attempting suicide and/or serious suicidal ideation or plans) in the past 2 weeks were invited to a clinical interview with a mental health professional. Of the 12,395 adolescents, 4.2 % (n = 516) screened positive for current suicidality. The prevalence ranged from 1.1 % in Hungary to 7.7 % in Israel (p < 0.001). 37.6 % (n = 194) of those who screened positive subsequently attended the clinical interview. Female students were more likely to attend for interview (42.0 % versus 30.6 %, p = 0.010). The attendance rate varied considerably across countries, from 5.7 % in Italy to 96.7 % in France (p < 0.001). Improved attendance was associated with using school as the only interview setting (Mean attendance rate, MAR = 88 vs. 31 %, p = 0.006) and arranging the interview within 1 week of contacting the student (MAR = 64 vs. 23 %, p = 0.013). The greater the travel time to interview, the lower the attendance rate (Pearson's r = -0.64, p = 0.034). Independent of the variation by country, at the individual level, adolescents with more depressive symptoms and a recent suicide attempt more often attended for interview. A high rate of current suicidality was found amongst European adolescents. However, the majority of these displayed limited help-seeking behaviour. Future studies should investigate ways of making screening programmes and other interventions more acceptable and accessible to young people, especially young males.

School-based suicide prevention programmes: the SEYLE cluster-randomised, controlled trial

Suicidal behaviours in adolescents are a major public health problem and evidence-based prevention programmes are greatly needed. We aimed to investigate the efficacy of school-based preventive interventions of suicidal behaviours. The Saving and Empowering Young Lives in Europe (SEYLE) study is a multicentre, cluster-randomised controlled trial. The SEYLE sample consisted of 11,110 adolescent pupils, median age 15 years (IQR 14-15), recruited from 168 schools in ten European Union countries. We randomly assigned the schools to one of three interventions or a control group. The interventions were: (1) Question, Persuade, and Refer (QPR), a gatekeeper training module targeting teachers and other school personnel, (2) the Youth Aware of Mental Health Programme (YAM) targeting pupils, and (3) screening by professionals (ProfScreen) with referral of at-risk pupils. Each school was randomly assigned by random number generator to participate in one intervention (or control) group only and was unaware of the interventions undertaken in the other three trial groups. The primary outcome measure was the number of suicide attempt(s) made by 3 month and 12 month follow-up. Analysis included all pupils with data available at each timepoint, excluding those who had ever attempted suicide or who had shown severe suicidal ideation during the 2 weeks before baseline. This study is registered with the German Clinical Trials Registry, number DRKS00000214. Between Nov 1, 2009, and Dec 14, 2010, 168 schools (11,110 pupils) were randomly assigned to interventions (40 schools [2692 pupils] to QPR, 45 [2721] YAM, 43 [2764] ProfScreen, and 40 [2933] control). No significant differences between intervention groups and the control group were recorded at the 3 month follow-up. At the 12 month follow-up, YAM was associated with a significant reduction of incident suicide attempts (odds ratios [OR] 0·45, 95% CI 0·24-0·85; p=0·014) and severe suicidal ideation (0·50, 0·27-0·92; p=0·025), compared with the control group. 14 pupils (0·70%) reported incident suicide attempts at the 12 month follow-up in the YAM versus 34 (1·51%) in the control group, and 15 pupils (0·75%) reported incident severe suicidal ideation in the YAM group versus 31 (1·37%) in the control group. No participants completed suicide during the study period. YAM was effective in reducing the number of suicide attempts and severe suicidal ideation in school-based adolescents. These findings underline the benefit of this universal suicide preventive intervention in schools. Coordination Theme 1 (Health) of the European Union Seventh Framework Programme.

Alcohol consumption patterns among adolescents are related to family structure and exposure to drunkenness within the family: results from the SEYLE project.

There is expedient evidence showing that differences in adolescent alcohol consumption and other risk-behaviour depend on both family structure and family member drunkenness exposure. Data were obtained among adolescents (N = 12,115, mean age 14.9 ± 0.89) in Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain within the European Union’s 7th Framework Programme funded project, ‘Saving and Empowering Young Lives in Europe (SEYLE)’. The current study reveals how adolescents’ alcohol consumption patterns are related to their family structure and having seen their family member drunk. The results revealed statistically significant differences in adolescent alcohol consumption depending on whether the adolescent lives in a family with both birth parents, in a single-parent family or in a family with one birth parent and one step-parent. The study also revealed that the abstaining from alcohol percentage among adolescents was greater in families with both birth parents compared to other family types. The study also showed that the more often adolescents see their family member drunk the more they drink themselves. There is no difference in adolescent drinking patterns whether they see their family member drunk once a month or once a week. This study gives an insight on which subgroups of adolescents are at heightened risk of alcohol abuse and that decrease of family member drunkenness may have positive effects on the drinking habits of their children.

EPA-0800 - Professional screening of “AT RISK” 14-16 year old adolescents in french schools: An ancilary study from the seyle cohort

The SEYLE (’ Saving and Empowering Young Lives in Europe ’) randomized clinical trial is funded by the European Union (FP7). Its aims were to collect baseline and follow-up data on health and well-being among European adolescents and to test three different suicidepreventive interventions, in comparison with a control group, in order to recommend culturally adjusted models for promoting mental health and preventing suicidal behaviors. The present ancillary study presents results of the French Prof-Screen cohort. 1: to describe the psychopathological profile of ’at risk’ students. 2: to compare the profiles of students referred vs. not referred to mental health services. 3: to analyse judgment criteria of the professional for referring pupils. The questionnaire was a composite of psychopathology scales: Beck Depression Inventory (BDI-II); Zung Self-Assessment Anxiety Scale (SAS), Paykel Scale, Delibarate Self-Harm Inventory (DSHI) and other questions addressing issues of substances use, social relationships... In the Prof-Screen arm, when critical scores were reached in the baseline questionnaire, the pupil was considered ’at risk’ and was examined by a professional who had to decide, based on a semi-structured interview and his/her clinical global impression, whether the pupil had to be referred to mental health services. among the 235 pupils in the Prof-Screen arm, 168 (71,5 %) were considered ’at risk’. 156 (92,9 %) were evaluated in the clinical interview, among which 38 cases (24,4 %) were referred to mental health facilities. major predictors for referral were depression, alcohol misuse and non suicidal self-injury.